New Delhi: Civil society activists, international and national public health experts and tobacco control advocates on Tuesday expressed shock at Union government's decision to defer the implementation of a notification for increasing the size of pictorial health warning on cigarette packets and various other tobacco products.

The deferment move comes in the wake of Parliamentary Committee on Subordinate Legislations (2014-15), headed by BJP MP Dilipkumar Mansukhhal Gandhi, examining the provisions of the Cigarettes and Other Tobacco Products Act, 2003, urging government to put on hold the proposed notification citing adverse impact on livelihood of people involved in the tobacco industry.

Representational image. AFP

"We are feeling very let down by this decision and shocked that the Health Ministry has revoked its decision because it may have a financial impact on revenue of tobacco industry and have overlooked their impact on illiterate and children," said Alok Mukhopadhyay, Chief Executive, Voluntary Health Association of India.

On 15 October, last year, the Union Health Ministry had issued a notification as per which 85 per cent space — 60 percent was to be devoted to pictoral warnings while 25 per cent for textual warnings from tomorrow. At present, the space covered by the warning is 40 per cent.

Dr P C Gupta, Director, Healis - Sekhsaria Institute for Public Health said, "The argument given by Dilip Gandhi that new studies should be conducted on the health effects of tobacco before implementing proposed warnings, makes us hang our heads in shame.

"When the whole world has agreed on the health effects of tobacco, even the tobacco industry does not contest those conclusions now and the MoHFW has already published numerous documents describing health effects, a demand for further study, can only imply unholy nexus," he said.

Supriya Sule, Lok Sabha, MP from Pune, Nationalist Congress Party said,"I appeal to the Honourable Prime Minister that it is essential that these warnings appear on tobacco products as soon as possible as the new pictorial warnings will reaffirm Indian global leadership, projecting India into one of the leading positions for the largest tobacco health warnings in the world," she said.

Following the 15 October, 2014 notification, India’s position jumped to 2nd from 136 (of 198 countries) in pictorial warnings. Taking the cue from India, countries like Nepal, Pakistan, Sri Lanka, dramatically increased the size of their pictorial warnings to 90 per cent, 85 per cent and 80 per cent respectively.

Over 50,000 representations were sent in support of the new pictorial warnings to Health Minister, from tobacco control advocates, thousands of students, doctors, cancer patients, bidi workers unions, women and youth groups, national and international public health experts.

A recent MoHFW-WHO supported PHFI study, estimated that the total economic costs attributable to tobacco use from all diseases in India in the year 2011 amounted to a staggering Rs 1, 04,500 crores — 12 per cent more than the combined state and central government expenditure on health care in the same year.

"India must act fast to protect its people, especially youth, from the dangerous effects of tobacco use and pictorial warnings are an effective way to communicate harms to those with poor literacy status," said Dr Monika Arora, Director, Health Promotion and Adjunct Associate Professor, Public Health Foundation of India.

Effective pictorial warning increase knowledge about risks associated with smoking and can decrease intentions to smoke among adolescents persuade smokers to quit, and keep ex-smokers from starting again.

Tobacco related diseases kills about 2500 Indians daily and over 10 lakh Indians every year. And it is estimated that about 5500 youth and children (as young as 8 years old), initiate tobacco use daily. India has 12 crore tobacco users, according to the Global Adult Tobacco Survey (GATS) 2009-2010.